Now that someone with mental illness has shot one of Washington's own, maybe Congress will start to pay attention to its abysmal failure to provide care for the most seriously mentally-ill Americans.

We'll see. Lawmakers took a brief lunge in that direction after mentally-ill John Hinckley shot Ronald Reagan in
1981, and an even smaller step in 1988 when Russel Weston, another
mentally-ill man, entered the Capitol and shot two police officers. But
most mentally-ill people are not violent -- and Congress seems content
with ignoring those who are.

When you read
Jared Loughner's rantings on YouTube, you're instantly transported back
to the 1980s, when mentally-ill Ted Kaczynski -- the Unabomber --
started a 20-year career of sending bombs through the mail. He was
caught only in 1995 -- after family members who read the Unabomber's
35,000-word psychotic manifesto, said, "That sounds like Ted," and told
the police.

The family had tried to get help for Kaczynski
before then -- but, like most families of people with serious mental
illness, faced a Catch-22. They are powerless to do anything other than
say, "Why don't you go to a doctor" until after the mentally ill person becomes dangerous.

Here's what Congress should do to save money, improve care and prevent violence:

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1) Prioritize the seriously mentally ill. Federal mental-health
dollars now go to an astonishing variety of social programs for the
worried-well, with little left for the seriously ill. Congress
should establish a federal definition of "serious mental illness" that
covers no more than 5 percent of the population and require all programs
that get federal mental-health funds to use at least 60 percent of
those funds for the seriously mentally ill.

SAMHSA just e-mailed to alert me that its children's book, "Play Day
in the Park," which "reinforces positive, healthy choices for children
ages 3 to 4," is back in print. This, when seriously mentally-ill people
are going homeless and untreated. But it's far worse; SAMHSA actually
funded a conference in California where a speaker taught participants
how to go off their antipsychotic medicines.

3) End or greatly
restructure the Federal Protection and Advocacy for Mentally Ill
Individuals Program (PAMII). The lawyers in this program occasionally do
good work -- but more often, they defend the right of people with
mental illness to go off treatment and be psychotic. They are the major
impediment to reforming involuntary-treatment laws.

Congress
should ban the use of any PAMII funds for lobbying against reform of
involuntary-treatment laws or working to prevent family members from
helping their loved ones, an especially big problem here in New York.

4) Provide seed money to states that want to make use of Involuntary
Outpatient Commitment Laws. These laws allow courts to order someone
with mental illness and a history of violence to stay in treatment if he
wants to stay in the community. By cutting down on arrests,
incarcerations and hospitalizations (not to mention dangerous), these
laws save money and lives while helping the mentally ill live
successfully in the community.

5) End the Institutions for
Mental Disease Exclusion in Medicaid law. This prevents states from
providing long-term care for people with mental illness.

If you
need long-term care for a disease that resides in any organ other than
the brain, Medicaid reimburses states for half the cost. But not if the
disease is in the brain. So states lock the front door and open the back
-- patients wind up in jail after committing some vile act only because
they were left untreated.

There are mental-health groups that will oppose these changes -- they're feeding nicely off the status quo.

If there is any sanity needed, it's in how Washington addresses mental illness.